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Beta-Lactam Antibiotics

Gerald R. Donowitz, M.D.,
and Gerald L. Mandell, M.D.

CephalosporinsCephalosporins have been grouped into "generations" on the basis of their spectrum of activity against gram-negative rods (Table 4). Since the pharmacologic characteristics of first- and second-generation cephalosporins have previously been reviewed,¹⁹⁷ ¹⁹⁸ ¹⁹⁹ ²⁰⁰ ²⁰¹ ²⁰² only selected aspects of the most important agents will be mentioned here.First- and Second-Generation CephalosporinsFirst-generation cephalosporins, such as the parenteral drugs cephalothin (Keflin, Seffin) and cefazolin (Ancef, Kefzol) and the oral agent cephalexin (Keflex), are the most active of all cephalosporins against staphylococci and nonenterococcal streptococci.¹⁹⁷ Methicillin-resistant staphylococci and penicillin-resistant pneumococci are usually resistant to these agents.²⁰³ Even in instances in which in vitro susceptibility . . .

Funding and Disclosures

We are indebted to Carol MacDonald, David Focht, Wilma Connelly, Colleen Harman, and Sue DeMasters for their aid in the preparation of this manuscript.

Author Affiliations

From the Infectious Diseases Division, Department of Internal Medicine, University of Virginia Medical Center, Box 385, Charlottesville, VA 22908, where reprint requests should be addressed to Dr. Donowitz.

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